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Successful treatment of vertebral osteomyelitis due to Aspergillus flavus in an immunocompetent patient
  1. Myong Gyu Joshua Kim1,2 and
  2. Kristen Overton1,2
  1. 1University of New South Wales, Prince of Wales Clinical School, Randwick, New South Wales, Australia
  2. 2Infectious Diseases, Prince of Wales Hospital and Community Health Services, Randwick, New South Wales, Australia
  1. Correspondence to Dr Myong Gyu Joshua Kim; myonggyu.kim{at}health.nsw.gov.au

Abstract

Aspergillus osteomyelitis (AO) is a rare and often lethal opportunistic infection in predominantly immunocompromised patients. Treatment has shifted from amphotericin therapy to voriconazole monotherapy due to increased effectiveness and less toxicity. We report a case of an immunocompetent woman with vertebral osteomyelitis due to Aspergillus flavus who was successfully treated with surgery (requiring hardware implantation) and monotherapy posaconazole (following intolerance and hepatitis due to voriconazole). She remained well at follow-up post cessation of 12 months of antifungal therapy. We provide an updated literature review examining the role of azole monotherapy as the gold standard of treatment for AO.

  • Infections
  • Bone and joint infections
  • Medical management
  • Neurosurgery

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Footnotes

  • Contributors MGJK was the primary author who drafted the manuscript including the literature review. KO was the senior author responsible for the conception of the manuscript and the revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note Each author certifies that this material has not been and will not be submitted to or published in any other publication.